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3/2/2018 Typology: Are There Addiction Subtypes? - Recovery Research Institute
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Typology: Are There Addiction
Subtypes?
While a group of individuals may all be
diagnosed and meet the criteria for a
substance use disorder, each member of that
group may experience di�erent symptoms and
patterns of substance use, and therefore
present with substance use disorder di�erently.
Our current diagnostic systems allows for individuals to
meet the threshold for a substance use disorder with
many di�erent combinations of symptoms. The variability
that exists between individuals, has lead researchers to
develop typologies, or measures that can be used to
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3/2/2018 Typology: Are There Addiction Subtypes? - Recovery Research Institute
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explain and classify addiction, given the varying
presentations and variety of symptom sub-types within
the disorder.
Typologies address the di�erent
etiological pathways and risk factors such
as:
Jellinek Typology: Subspecies of
Alcoholism
Cloninger et al: Type I and II
U.S. Drug Classi�cations
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family history (genetic etiology)•
symptom pro�les•
psychological history (psychiatric comorbidities)•
environmental exposures•
social context•
Alpha: psychologically driven substance use
that may or may not lead to neuroadaptation.•
Beta: continuous heavy drinking resulting in
physical problems•
Gamma: classic loss of control type of symptom
pro�le•
Delta: inability to stop drinking; continual
drinking to avoid withdrawal symptoms•
Epsilon: binge/episodic pattern of drinking•
3/2/2018 Typology: Are There Addiction Subtypes? - Recovery Research Institute
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Babor : Type A and B
Twelve-Step Facilitation
(TSF)
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Type I:•Mild to severe alcohol use•
Relatively high socioeconomic status•
Maternal alcohol use•
No criminality among fathers•
More responsive to environmental
in�uence•
Relatively mild alcohol problems•
Late age of onset (>25 years)•
Type II:•Positive family history of alcohol use•
Severe alcohol problems•
Other drug use•
Early onset (<25 years)•
Type A:•Late age of onset•
Fewer childhood behavior problems•
Less psychopathology•
Type B:•Childhood behavior problems•
Family history of alcohol use•
Early onset of alcohol problems•
More psychopathology•
More life stress•
More chronic treatment history•
3/2/2018 Typology: Are There Addiction Subtypes? - Recovery Research Institute
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Hesselbrock: 4 Subtypes of Alcoholism
Moss et al: 5 Clusters of Alcohol Dependence
Young adult subtype
Functional subtype
Intermediate Familial Subtype
Young Antisocial Subtype
Chronic Severe Subtype
Most recently, typologies
for pharmacogenetics have emerged.
Nonproblem drinkers•
Mild alcoholics•Persistent desire to stop using•
Tolerance•
Blackouts•
Moderate alcoholics•Social, health and emotional problems•
Severely a�ected alcoholics•Withdrawal•
Inability to stop drinking•
Craving•
Health and emotional problems•
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Some individuals with certain genotypes may respond
better (or worse) to certain pharmacological approaches
to treating substance use disorder. For example, some
studies have found that individuals with alcohol
dependence who possess a certain receptor gene (OPRMI
mu opioid receptor gene AS40) have a better treatment
response to the medication naltrexone than those who do
not possess the gene.
For another example, see Kranzler et al. 2014:
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